Regionalizing Care for Acute Myocardial Infarction: Beware the Cookie Cutter

A careful analysis of hospital-level and regional data suggests that the capability for percutaneous coronary intervention does not guarantee better outcomes.

Support for the regionalization of care for ST-segment-elevation myocardial infarction (STEMI) is based on the assumption that outcomes are better when patients are treated at centers with percutaneous coronary intervention (PCI) facilities than at centers without these facilities. Although intuitively sensible, this assumption has not been rigorously tested.

Now, investigators have examined Medicare claims data on more than 700,000 patients hospitalized for acute MI in the U.S. between 2004 and 2006 and compared risk-standardized mortality rates (RSMRs) between 1382 centers with PCI facilities and 2491 centers without PCI facilities in 295 healthcare regions. Outcomes for patients who were transferred were attributed to the first centers at…

Reviewing Author

Frederick A. Masoudi, MD, MSPH

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)

Frederick A. Masoudi, MD, MSPH

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)